RARE DISEASE
Wound myiasis
Wound myiasis
Wound myiasis
Synonyms: Traumatic myiasis
Synonyms: Traumatic myiasis
Synonyms: Traumatic myiasis
Drug discovery
306
papers
On emerging therapies
Overview
Wound myiasis is a parasitic infestation caused by fly larvae developing in necrotic or living tissue of open wounds. Predominantly observed in tropical regions, it affects individuals with chronic wounds, poor hygiene, or comorbidities like diabetes. Larvae can cause tissue destruction, secondary infections, and psychological distress, necessitating prompt removal and antimicrobial therapy [1][6][12].
Population
Common in homeless individuals, elderly, alcoholics, and those with chronic conditions (e.g., diabetes, cancer, peripheral vascular disease) [2][7][12].
Associated with neglected wounds, particularly in tropical climates or low-resource settings [4][6][14].
Nosocomial cases occur occasionally, often linked to immobility or complex wounds [2][8].
Burden
Therapies
Mechanical removal: Larval extraction via forceps, irrigation, or surgical debridement [1][18][16].
Topical agents: Turpentine, chloroform, or ivermectin to asphyxiate or expel larvae [3][10][12].
Systemic therapy: Ivermectin, albendazole, and antibiotics to address infestation and secondary infections [3][10][13].
Categories: rare infectious diseases
Research Papers
306 drug discovery papers about Wound myiasis. Recent publications:
306 drug discovery papers about Wound myiasis. Recent publications:
categories:
Small molecules
small molecules
2026-09-15 | Efficacy of (R)-limonene, α-terpinene, terpinolene and β-pinene against Cochliomyia hominivorax (New World screwworm) in vitro and in vivo evaluations.
Cochliomyia hominivorax (screwworm fly) has a veterinary and public health importance, as it is the primary agent of myiasis in both livestock and humans across the Americas. This fly oviposits in fresh, open wounds, where the larvae feed on living tissue, compromising animal health and livestock productivity. Furthermore, the efficacy of conventional insecticides has decreased, suggesting the development of parasite resistance. Terpenes are major constituents of essential oils known for their insecticidal properties. The objective of this study was to evaluate the terpenes (R)-limonene, α-terpinene, terpinolene, and β-pinene against the first (L1), second (L2), and third (L3) larval instars of C. hominivorax. Among the evaluated terpenes, α-terpinene exhibited the highest lethality, with the lowest concentration required to kill 95% of the larvae (LC95) and was incorporated into an ointment at a concentration of 200 mg/g for in vivo testing. Twelve Holstein cattle were used in the study. Six control animals received bilateral 3 cm incisions in the gluteal region: one side was inoculated with 50 L1 larvae (untreated control), while the contralateral side received 50 L1 larvae plus the ointment vehicle (negative control). Another six cattle, each with a single gluteal lesion inoculated with 50 L1 larvae, were treated with the α-terpinene ointment, which was reapplied after 24 and 48 h. After 72 h, the surviving L3 larvae were recovered, counted, and measured. The α-terpinene ointment treatment showed no significant efficacy, as no differences were found in larval recovery rates between groups. However, larvae exposed to α-terpinene were significantly smaller compared to those in the untreated control and the vehicle control groups suggesting a relevant sub-lethal effect on parasite development. The discrepancy between the in vitro larvicidal activity and the limited in vivo efficacy may stem from the rapid volatilization of α-terpinene or its uneven distribution within the wound environment highlighting further optimization of the vehicle to maintain therapeutic concentrations and achieve full efficacy.
2026-06-01 | GD11 An atypical presentation of cutaneous myiasis of the scalp
Abstract Myiasis is an ectoparasitic infestation caused by larvae of arthropods in the order Diptera. Cutaneous myiasis is the infection of skin and includes the following types: furuncular, migratory and wound myiasis. Out of all the organisms responsible for this disease, Wohlfahrtia vigil is the most common causative agent in Pakistan, usually seen from June to September, with nearly all patients presenting at a young age. In our case a patient without a history of trauma, skin erosion or animal exposure portrayed a unique presentation. Here, an effort was made to treat a 15-year-old otherwise healthy girl with an unusual presentation of cutaneous myiasis with a multisegmented treatment modality. Follow-up visits were conducted every 3 days for 3 months, at the end of which a 60% decrease in the size of the open wound was seen. Myiasis is a rare but preventable disease, which is very likely to spread in the rural population, the majority of Pakistan. Poor hygiene status, overcrowding and the presence of stray animals provide a breeding ground for the botfly responsible for myiasis. The population needs to be educated regarding good personal and social hygiene, especially in areas where flies are inherent and can cause direct inoculation. However, direct inoculation can be considered a mode of transmission despite good personal hygiene, as in this atypical presentation. Measures should be taken to keep residential areas and farms separate, to dispose of waste away from homes, and to use nets and insecticides while sleeping outside. Educational camps should be set up to spread awareness regarding myiasis, especially cutaneous myiasis of the oral cavity, ear and scalp, which needs to be diagnosed early due to proximity to the brain. Timely removal of larvae and irrigation of the area can prevent detrimental side effects and comorbidities.
2026-06-01 | Apus bamboo shoot extract formulation accelerates the healing of myiasis-infected wounds in Wistar rats
Myiasis, a type of tissue infection caused by fly larvae, can lead to significant tissue damage and delayed wound healing. Conventional treatment with antibiotics and larvicides often poses risks of resistance and side effects. This study aimed to evaluate the effectiveness of apus bamboo shoot (Gigantochloa apus) extract in accelerating wound healing caused by myiasis infection in Wistar rats. Twenty-five Wistar rats were divided into five groups: a negative control (CN) group, a positive control (CP) with ivermectin, and three groups treated with 1%, 3%, and 5% apus bamboo shoot extract. Compared with the positive control (ivermectin), 5% apus bamboo shoot extract (P3) had the greatest effect on reducing wound length on days 7 and 11. Histopathological analysis revealed improved granulation tissue formation, increased fibroblast number, and reduced inflammation. Compared to the negative control group, the inflammatory cell counts were lower in all treatment groups, with significant decreases observed in groups treated with %, and 5% apus bamboo shoot extract. The apus bamboo shoot extract has potential as an effective natural treatment for myiasis wound healing, with bioactive compounds contributing to its anti-inflammatory, antibacterial, and larvicidal properties. However, further clinical studies are required to confirm its applicability.
2026-05-14 | Management of myiasis in advanced head and neck cancers: a comprehensive review.
Accidental myiasis, defined as the infestation of living or necrotic tissue by Diptera larvae, represents a neglected but profoundly distressing complication in patients afflicted with advanced malignancies, particularly head and neck cancers (HNC). HNC constitutes a major global health burden, with an exceptionally high incidence in low- and middle-income countries (LMICs), such as India, where delayed presentation often culminates in large, ulcerative malignant fungating wounds (MFWs). These MFWs, coupled with environmental factors, socioeconomic disadvantage, poor hygiene, and patient debility, create a fertile environment for obligatory parasitic fly species, notably Chrysomyia bezziana and Cochliomyia hominivorax, whose larvae aggressively destroy host tissues. The resulting infestation leads to severe pain, relentless odor, rapid tissue erosion, and profound psychological distress, demanding urgent and definitive intervention. Given the paucity of standardized protocols, this review synthesizes the current global and Indian evidence (2000-2025) on the pathophysiology, clinical burden, and management of malignant wound myiasis. The evidence strongly supports an integrated approach centered on systemic antiparasitic administration. Specifically, the "Triple Therapy" regimen-Oral ivermectin, albendazole, and clindamycin-is highlighted for its promising efficacy reported in a single-center prospective cohort in achieving rapid clearance (> 90% reduction in larval burden by Day 3) and significantly improving associated palliative metrics, including pain and odor control. Practical guidelines emphasizing patient safety, ethical use of topical agents, and the essential role of comprehensive psychosocial and caregiver support are provided to establish a high-value, patient-centered standard of care.
2026-03-01 | Therapeutic efficacy and clinical evaluation of a topical polyherbal veterinary formulation (HEALYN SPRAY) in the management of caprine wounds and dermatological disorders: A six-month prospective field study
Wound infections and dermatological disorders in goats significantly compromise productivity, welfare, and economic sustainability in small ruminant farming systems. Delayed wound management predisposes animals to secondary bacterial infection, myiasis, septicemia, and potentially fatal tetanus caused by Clostridium tetani. The present prospective clinical field investigation was conducted over six months to evaluate the therapeutic efficacy, safety, and healing kinetics of a topical polyherbal veterinary formulation, HEALYN SPRAY, in naturally occurring caprine wounds. A total of 120 goats presenting with septic wounds, aseptic wounds, deep lacerations, horn injuries, maggot-infested wounds, dermatophytosis and mange were enrolled. Wounds were graded on a standardized ordinal severity scale and treated with twice-daily topical application. Clinical response was evaluated using inflammation score reduction, exudate grading, granulation index, wound contraction percentage and healing time. Statistical analysis was performed using mean±standard deviation and paired t-test comparisons at p
proteins
2025-06-30 | A Case of Traumatic Myiasis Caused by Wohlfahrtia magnifica in a Dog
A 6-months-old female stray dog with tissue loss was brought to a private veterinary clinic. As a result of the examination of the dog, a 10 cm-wide wound with tissue loss was observed in the neck region. A large number of live fly larvae were detected from the wound. Larvae were carefully taken into petri dishes and kept in 70% ethyl alcohol. The collected larvae were cleared in 10% KOH solution. Species identifications were made in the microscopic examination of the larvae in the parasitology laboratory, according to the morphological features of the anterior and posterior stigma and the cephalo-pharyngeal skeleton. Larvae were identified as II and III instar larvae of Wohlfahrtia magnifica. A total of 65 live larvae were collected, 57 of which were L3 and 8 were L2.
2023-05-09 | Evaluation of the Antibacterial Activity of Chrysomya albiceps Larval Extract and its Synergistic Effects with Antibiotics
Antimicrobial resistance is currently a significant global problem.The medical field is currently suffering from a shortage of effective treatments to prevent infections since the emergence rate of multidrug resistance has exceeded the rate of discovery and creation of new effective drugs.This study evaluates the antibacterial activity of the excretions/secretions of Egyptian calliphorid larvae, Chrysomya albiceps (C.albiceps), in vitro on the development of five pathogenic bacterial species (methicillin-sensitive Staphylococcus aureus ATCC 29213, methicillin-resistant Staphylococcus aureus ATCC BAA-1680, Pseudomonas aeruginosa ATCC 27853, Escherichia coli ATCC 25922 and Salmonella typhi ATCC 19430) via different assays.Resazurin-based 25turbidimetric assay (RTBA) proved that C. albiceps larval exosecretions (ES) was effective against all examined bacterial species, which also determined the minimum inhibitory concentration (MIC) for each bacterium.By using a colony-forming unit (CFU) assay, MICs of C. albiceps ES exhibited bacteriostatic activity against all tested bacteria.All the bacterial models could not recover after 24 hrs of the incubation period.However, high concentration (200 mg/ml) showed bactericidal activity towards P. aeruginosa.The potency of C. albiceps extract toward gram-negative bacteria has been proven by agar disc diffusion assay which failed to show any antibacterial efficiency of ES toward gram-positive bacteria.Synergism between larval ES and commercial antibiotics against all bacterial species was observed.The present data is promising and using these combinations can lead to a reduction in the minimum dose required for effective antimicrobial effects which is important because it may decrease both the risk of side effects and the costs of treatment of infectious diseases.
2020-04-01 | Antibacterial Activities of Chrysomya albiceps Maggots’ Extracts (Diptera: Calliphoridae)
Maggot therapy's success is partly due to the ingestion and killing of living microorganisms. The aim of this study was to investigate the antibacterial activities of maggots’ crude extracts (DMSO and PBS extracts) and excretion/secretion of Chrysomya albiceps (Diptera: Calliphoridae). The excretion/secretion (E/S) and crude extracts were collected from third larval instars of C. albiceps. The extracts were tested against Escherichia coli and Pseudomonous aeruginosa, as Gram-negative bacteria and Staphylococcus aureus and Bacillus subtilis as Gram-positive bacteria. Antimicrobial activity was done by calculating the reduction percentage of the colony's growth. The E/S was appeared the highest antibacterial activities against Gram-positive and Gram-negative bacteria, while the PBS extract has appeared the lower antibacterial activities. Generally, the E/S of C. albiceps maggot was found to be more effective as antibacterial agents than crude extracts (DMSO and PBS extracts).
2017-07-01 | Molecular characterization of matrix metalloproteinase-1 (MMP-1) in Lucilia sericata larvae for potential therapeutic applications
The salivary glands of Lucilia sericata are the first organs to express specific endopeptidase enzymes. These enzymes play a central role in wound healing, and they have potential to be used therapeutically. Rapid amplification of cDNA ends and rapid amplification of genomic ends were used to identify the coding sequence of MMP-1 from L. sericata. Different segments of MMP1 gene, namely the middle part, 3′ end, and 5′ end, were cloned, sequenced, and analyzed using bioinformatics tools to determine the distinct features of MMP-1 protein. Assembling the different segments revealed that the complete mRNA sequence of MMP-1 is 1932 bp long. CDS is 1212 bp long and is responsible for the production of MMP-1 of 404 amino acid residues with a predicted molecular weight of 45.1 kDa. The middle part, 3′ end, and 5′ end sequences were 933, 503, and 496 bp. In addition, it was revealed that the MMP-1 genomic sequence includes three exons and two introns. Furthermore, the three-dimensional structure of L. sericata MMP-1 protein was evaluated, and its alignment defined that it has high similarity to chain A of human MMP-2 with 100% confidence, 72% coverage, and 38% identity according to the SWISS-MODEL modeling analysis. MMP-1 of L. sericata has a close relationship with its homologs in invertebrates and other insects. The present study significantly contributes to understanding the function, classification, and evolution of the characterized MMP-1 from L. sericata and provides basic required information for the development of an effective medical bioproduct.
2016-11-21 | The transcriptional responses of cultured wound cells to the excretions and secretions of medicinal Lucilia sericata larvae.
Maggots, through their excretions and secretions (ES), promote wound healing by removing necrotic tissue, counter bacterial infection, and activate wound associated cells. We investigated the effects of a physiological dose of maggot ES on four wound-associated cell types in vitro with Affymetrix gene expression arrays; keratinocytes, endothelial cells, fibroblasts, and monocytes. Keratinocytes showed the fewest (n = 5; p < 0.05, fold-change ±2) and smallest fold-changes (up to 2.32×) in gene expression and conversely THP1 monocytes had the most (n = 233) and greatest magnitude (up to 44.3×). There were no genes that were altered in all four cell-lines. Gene pathway analysis identified an enrichment of immune response pathways in three of the treated cell-lines. Analyses by quantitative RT-PCR found many genes dynamically expressed in ES dose dependent manner during the three day treatments. Phenotype analyses, however, found no effects of ES on cell viability, proliferation, migration and angiogenesis. ES was 100× less potent at triggering IL-8 secretion than fibroblasts treated with purified bacterial lipopolysaccharide (LPS; in equivalent amounts to that found in ES; ∼40 EU/ml). Furthermore, co-treatment with LPS and ES decreased the LPS-alone triggered IL-8 secretion by 13%. Although ES had no direct effect on wound cell phenotypes it did partially reduce the immune response to bacterial LPS exposure. These observations were consistent with the profile of transcriptional responses that were dominated by modulation of immune response genes. Maggot therapy may therefore improve wound healing through the secondary effects of these gene changes in the wound cells.
cell therapies
2025-11-03 | What is the best way to care for a myiasis wound?
The management of myiasis wounds centers on manual removal of larvae, thorough cleaning, and preventing secondary infections, with options like Maggot Debridement Therapy offering biologically based debridement.
2025-08-11 | Beyond Myiasis: Understanding Environmental Factors, Maggots, and Infection Risks in Xylazine-Associated Wounds.
The emergence of xylazine-associated wounds, highlighted by case reports from Philadelphia in 2022, has been linked to the use of this veterinary sedative as an adulterant in the unregulated drug supply and has brought renewed attention to the challenges of complex wound management, particularly in vulnerable populations. Among these challenges are unusual infectious complications, including cases of larva-associated infections such as Ignatzschineria bacteremia in maggot-colonized wounds, raising critical questions about the role of environmental exposure, wound neglect, and the presence of maggots. Clinicians must recognize that rare infections often arise not from the drug itself but from environmental exposure and delayed wound care. Furthermore, it is essential to distinguish between uncontrolled myiasis (spontaneous, unsanitary maggot infestation) and the therapeutic application of sterile Lucilia sericata larvae through medically supervised larval therapy. Building on historical observations and contemporary wound care literature, we explore how larval therapy offers a precise, cost-effective method for wound debridement, particularly valuable in situations in which definitive surgical care is delayed or unfeasible. As clinicians confront the rising burden of xylazine-related wounds, a nuanced understanding of environmental infectious risks and biosurgical interventions can expand the surgeon's wound care armamentarium and improve outcomes not only for patients with drug-induced wounds but also for individuals with chronic wounds.
2024-02-16 | Therapeutic Potential in Wound Healing of Allogeneic Use of Equine Umbilical Cord Mesenchymal Stem Cells
Wound healing after skin injury is a complex process, particularly in equines where leg wounds are prevalent and their repair is complicated due to the anatomical characteristics. Conventional treatments are not effective enough. The umbilical cord offers an unlimited source of adult mesenchymal stem cells (ucMSCs) from Wharton’s jelly tissue. The present study aims to demonstrate the safety and therapeutic potential of the allogeneic use of equine ucMSCs (e-ucMSCs) in the healing of severe equine leg wounds. The methods employed were the isolation, culture and expansion of e-ucMSCs. Flow cytometry and a PCR assay were used for cell characterization. This study included an immunomodulation assay, a murine pre-clinical trial and the first phase of an equine clinical trial. Our results showed that e-ucMSCs express a functional HLA-G homolog, EQMHCB2. In the immunomodulation assay, the e-ucMSCs inhibited the proliferation of activated equine peripheral blood mononuclear cells (e-PBMCs). In the murine pre-clinical trial, e-ucMSCs reduced healing time by 50%. In the equine clinical trial, the injection of e-ucMSCs into severe leg lesions improved the closure time and quality of the tissues involved, regenerating them without fibrous tissue scar formation. In conclusion, the results of this study suggest that e-ucMSCs can be used allogeneically for wound healing by creating a tolerogenic environment.
2022-12-18 | Exploring the Effects of Lucilia sericata Larvae on Biofilm-forming Bacteria in Wounds
Objective: Biofilm-induced chronic wound infections are among the most significant causes of treatment failures. Healing chronic wounds with biofilm is a major issue worldwide due to high costs and adverse effects on patients. In this study, we aimed to investigate the impacts of Lucilia sericata larvae on biofilm-forming bacteria in chronic wounds.
Method: We recruited 30 patients applying to Istanbul University-Cerrahpasa, Traditional and Complementary Medicine Research and Application Center, Wound Healing Unit, between December 2019 and March 2021. We obtained swab cultures before and immediately after applying Larval Debridement Therapy (LDT). After identifying isolated bacteria, we examined all agents by susceptibility and biofilm formation.
Results: While isolating only a single bacterial genus/species in 19 patients, we could detect more than one bacterial genus/species in 11 of them. Moreover, we observed biofilm formation in bacteria isolated from 21 patients, but it was not the case in bacteria grown in 9 patients. Following LDT, we discovered that the biofilm layer on wounds was removed in a short time (two to three sessions).
Conclusion: Although many methods are adopted in healing chronic wounds with biofilm formation, they often remain ineffective. The therapy with L. sericata larvae, a simple and effective method, may promote rapid healing of biofilm-forming wounds.
2022-06-28 | A systematic review of effective bioagent in chronic wounds: The maggot biotherapy pyramid
Wound assessment is important in monitoring the effectiveness of treatment in chronic wounds.Therefore, a holistic approach is needed when evaluating effective wound treatment.Most chronic wounds require complementary treatment approaches and conventional treatments in modern medicine.This research was carried out by compiling studies on the past, present, and future of maggot (medical larvae) that cure nonhealing/hard-to-heal wounds; therapeutic larva types, therapy method, healing mechanism, wound healing effect with clinical studies, different usage areas and biological activities of the larvae and the metabolite components in the secretions that provide these activities.In conclusion, medical larvae applied with traditional and complementary medicine techniques to treat nonhealing, difficult-to-heal wounds have a wound-healing effect.However, more research is needed to identify the metabolite components in their secretions that provide their mechanism of action and biological activities.
gene therapies
2022-05-29 | Genomic insights into evolution and control of Wohlfahrtia magnifica, a widely distributed myiasis-causing fly of warm-blooded vertebrates.
Wohlfahrtia magnifica is a pest fly species, invading livestock in many European, African and Asian countries, and causing heavy agroeconomic losses. In the life cycle of this obligatory parasite, adult flies infect the host by depositing the first-stage larvae into body cavities or open wounds. The feeding larvae cause severe (skin) tissue damage and potentially fatal infections if untreated. Despite serious health detriments and agroeconomic concerns, genomic resources for understanding the biology of W. magnifica have so far been lacking. Here, we present a complete genome assembly from a single adult female W. magnifica using a Low-DNA Input workflow for PacBio HiFi library preparation. The de novo assembled genome is 753.99 Mb in length, with a scaffold N50 of 5.00 Mb, consisting of 16,718 predicted protein-encoding genes. Comparative genomic analysis revealed that W. magnifica has the closest phylogenetic relationship to Sarcophaga bullata followed by Lucilia cuprina. Evolutionary analysis of gene families showed expansions of 173 gene families in W. magnifica that were enriched for gene ontology (GO) categories related to immunity, insecticide-resistance mechanisms, heat stress response and cuticle development. In addition, 45 positively selected genes displaying various functions were identified. This new genomic resource contributes to the evolutionary and comparative analysis of dipterous flies and an in-depth understanding of many aspects of W. magnifica biology. Furthermore, it will facilitate the development of novel tools for controlling W. magnifica infection in livestock.
other
2024-01-04 | Antennal Transcriptome and Proteome Analysis of Olfactory Genes and Tissue Expression Profiling of Odorant Binding Proteins in Wohlfahrtia magnifica
Wohlfahrtia magnifica is a species of fly that parasitizes Bactrian camels.The adult flies lay their larvae near the vulva of the camels, and these larvae develop and cause damage to the vaginal tissues, resulting in vaginal myiasis.Olfactory organs play an important role in the identification and location of host, foraging, mating and oviposition behavior of W. magnifica.Olfactory genes were identified by antennal transcriptome analysis.Twenty-four odor-binding proteins (OBPs) and two chemosensory proteins (CSPs) were identified in the antenna transcriptome of W. magnifica, and then the phylogenetic analysis of the olfactory genes of W. magnifica and other species was carried out.RT-qPCR was used for the first time to analyze the expression profile of OBPs in the antenna tissues of the W. magnifica.In the tissue expression analysis of OBP genes, it was found that many of them showed obvious gender bias in antennae, indicating their different roles in identifying pheromones.These results will help to lay a foundation for the future research on the sense of smell of W. magnifica and help to better reveal the change of odor reception of W. magnifica and provide new ideas for the research on biological prevention and control of vaginal myiasis.
small molecules
2026-09-15 | Efficacy of (R)-limonene, α-terpinene, terpinolene and β-pinene against Cochliomyia hominivorax (New World screwworm) in vitro and in vivo evaluations.
Cochliomyia hominivorax (screwworm fly) has a veterinary and public health importance, as it is the primary agent of myiasis in both livestock and humans across the Americas. This fly oviposits in fresh, open wounds, where the larvae feed on living tissue, compromising animal health and livestock productivity. Furthermore, the efficacy of conventional insecticides has decreased, suggesting the development of parasite resistance. Terpenes are major constituents of essential oils known for their insecticidal properties. The objective of this study was to evaluate the terpenes (R)-limonene, α-terpinene, terpinolene, and β-pinene against the first (L1), second (L2), and third (L3) larval instars of C. hominivorax. Among the evaluated terpenes, α-terpinene exhibited the highest lethality, with the lowest concentration required to kill 95% of the larvae (LC95) and was incorporated into an ointment at a concentration of 200 mg/g for in vivo testing. Twelve Holstein cattle were used in the study. Six control animals received bilateral 3 cm incisions in the gluteal region: one side was inoculated with 50 L1 larvae (untreated control), while the contralateral side received 50 L1 larvae plus the ointment vehicle (negative control). Another six cattle, each with a single gluteal lesion inoculated with 50 L1 larvae, were treated with the α-terpinene ointment, which was reapplied after 24 and 48 h. After 72 h, the surviving L3 larvae were recovered, counted, and measured. The α-terpinene ointment treatment showed no significant efficacy, as no differences were found in larval recovery rates between groups. However, larvae exposed to α-terpinene were significantly smaller compared to those in the untreated control and the vehicle control groups suggesting a relevant sub-lethal effect on parasite development. The discrepancy between the in vitro larvicidal activity and the limited in vivo efficacy may stem from the rapid volatilization of α-terpinene or its uneven distribution within the wound environment highlighting further optimization of the vehicle to maintain therapeutic concentrations and achieve full efficacy.
2026-06-01 | GD11 An atypical presentation of cutaneous myiasis of the scalp
Abstract Myiasis is an ectoparasitic infestation caused by larvae of arthropods in the order Diptera. Cutaneous myiasis is the infection of skin and includes the following types: furuncular, migratory and wound myiasis. Out of all the organisms responsible for this disease, Wohlfahrtia vigil is the most common causative agent in Pakistan, usually seen from June to September, with nearly all patients presenting at a young age. In our case a patient without a history of trauma, skin erosion or animal exposure portrayed a unique presentation. Here, an effort was made to treat a 15-year-old otherwise healthy girl with an unusual presentation of cutaneous myiasis with a multisegmented treatment modality. Follow-up visits were conducted every 3 days for 3 months, at the end of which a 60% decrease in the size of the open wound was seen. Myiasis is a rare but preventable disease, which is very likely to spread in the rural population, the majority of Pakistan. Poor hygiene status, overcrowding and the presence of stray animals provide a breeding ground for the botfly responsible for myiasis. The population needs to be educated regarding good personal and social hygiene, especially in areas where flies are inherent and can cause direct inoculation. However, direct inoculation can be considered a mode of transmission despite good personal hygiene, as in this atypical presentation. Measures should be taken to keep residential areas and farms separate, to dispose of waste away from homes, and to use nets and insecticides while sleeping outside. Educational camps should be set up to spread awareness regarding myiasis, especially cutaneous myiasis of the oral cavity, ear and scalp, which needs to be diagnosed early due to proximity to the brain. Timely removal of larvae and irrigation of the area can prevent detrimental side effects and comorbidities.
2026-06-01 | Apus bamboo shoot extract formulation accelerates the healing of myiasis-infected wounds in Wistar rats
Myiasis, a type of tissue infection caused by fly larvae, can lead to significant tissue damage and delayed wound healing. Conventional treatment with antibiotics and larvicides often poses risks of resistance and side effects. This study aimed to evaluate the effectiveness of apus bamboo shoot (Gigantochloa apus) extract in accelerating wound healing caused by myiasis infection in Wistar rats. Twenty-five Wistar rats were divided into five groups: a negative control (CN) group, a positive control (CP) with ivermectin, and three groups treated with 1%, 3%, and 5% apus bamboo shoot extract. Compared with the positive control (ivermectin), 5% apus bamboo shoot extract (P3) had the greatest effect on reducing wound length on days 7 and 11. Histopathological analysis revealed improved granulation tissue formation, increased fibroblast number, and reduced inflammation. Compared to the negative control group, the inflammatory cell counts were lower in all treatment groups, with significant decreases observed in groups treated with %, and 5% apus bamboo shoot extract. The apus bamboo shoot extract has potential as an effective natural treatment for myiasis wound healing, with bioactive compounds contributing to its anti-inflammatory, antibacterial, and larvicidal properties. However, further clinical studies are required to confirm its applicability.
2026-05-14 | Management of myiasis in advanced head and neck cancers: a comprehensive review.
Accidental myiasis, defined as the infestation of living or necrotic tissue by Diptera larvae, represents a neglected but profoundly distressing complication in patients afflicted with advanced malignancies, particularly head and neck cancers (HNC). HNC constitutes a major global health burden, with an exceptionally high incidence in low- and middle-income countries (LMICs), such as India, where delayed presentation often culminates in large, ulcerative malignant fungating wounds (MFWs). These MFWs, coupled with environmental factors, socioeconomic disadvantage, poor hygiene, and patient debility, create a fertile environment for obligatory parasitic fly species, notably Chrysomyia bezziana and Cochliomyia hominivorax, whose larvae aggressively destroy host tissues. The resulting infestation leads to severe pain, relentless odor, rapid tissue erosion, and profound psychological distress, demanding urgent and definitive intervention. Given the paucity of standardized protocols, this review synthesizes the current global and Indian evidence (2000-2025) on the pathophysiology, clinical burden, and management of malignant wound myiasis. The evidence strongly supports an integrated approach centered on systemic antiparasitic administration. Specifically, the "Triple Therapy" regimen-Oral ivermectin, albendazole, and clindamycin-is highlighted for its promising efficacy reported in a single-center prospective cohort in achieving rapid clearance (> 90% reduction in larval burden by Day 3) and significantly improving associated palliative metrics, including pain and odor control. Practical guidelines emphasizing patient safety, ethical use of topical agents, and the essential role of comprehensive psychosocial and caregiver support are provided to establish a high-value, patient-centered standard of care.
2026-03-01 | Therapeutic efficacy and clinical evaluation of a topical polyherbal veterinary formulation (HEALYN SPRAY) in the management of caprine wounds and dermatological disorders: A six-month prospective field study
Wound infections and dermatological disorders in goats significantly compromise productivity, welfare, and economic sustainability in small ruminant farming systems. Delayed wound management predisposes animals to secondary bacterial infection, myiasis, septicemia, and potentially fatal tetanus caused by Clostridium tetani. The present prospective clinical field investigation was conducted over six months to evaluate the therapeutic efficacy, safety, and healing kinetics of a topical polyherbal veterinary formulation, HEALYN SPRAY, in naturally occurring caprine wounds. A total of 120 goats presenting with septic wounds, aseptic wounds, deep lacerations, horn injuries, maggot-infested wounds, dermatophytosis and mange were enrolled. Wounds were graded on a standardized ordinal severity scale and treated with twice-daily topical application. Clinical response was evaluated using inflammation score reduction, exudate grading, granulation index, wound contraction percentage and healing time. Statistical analysis was performed using mean±standard deviation and paired t-test comparisons at p
proteins
2025-06-30 | A Case of Traumatic Myiasis Caused by Wohlfahrtia magnifica in a Dog
A 6-months-old female stray dog with tissue loss was brought to a private veterinary clinic. As a result of the examination of the dog, a 10 cm-wide wound with tissue loss was observed in the neck region. A large number of live fly larvae were detected from the wound. Larvae were carefully taken into petri dishes and kept in 70% ethyl alcohol. The collected larvae were cleared in 10% KOH solution. Species identifications were made in the microscopic examination of the larvae in the parasitology laboratory, according to the morphological features of the anterior and posterior stigma and the cephalo-pharyngeal skeleton. Larvae were identified as II and III instar larvae of Wohlfahrtia magnifica. A total of 65 live larvae were collected, 57 of which were L3 and 8 were L2.
2023-05-09 | Evaluation of the Antibacterial Activity of Chrysomya albiceps Larval Extract and its Synergistic Effects with Antibiotics
Antimicrobial resistance is currently a significant global problem.The medical field is currently suffering from a shortage of effective treatments to prevent infections since the emergence rate of multidrug resistance has exceeded the rate of discovery and creation of new effective drugs.This study evaluates the antibacterial activity of the excretions/secretions of Egyptian calliphorid larvae, Chrysomya albiceps (C.albiceps), in vitro on the development of five pathogenic bacterial species (methicillin-sensitive Staphylococcus aureus ATCC 29213, methicillin-resistant Staphylococcus aureus ATCC BAA-1680, Pseudomonas aeruginosa ATCC 27853, Escherichia coli ATCC 25922 and Salmonella typhi ATCC 19430) via different assays.Resazurin-based 25turbidimetric assay (RTBA) proved that C. albiceps larval exosecretions (ES) was effective against all examined bacterial species, which also determined the minimum inhibitory concentration (MIC) for each bacterium.By using a colony-forming unit (CFU) assay, MICs of C. albiceps ES exhibited bacteriostatic activity against all tested bacteria.All the bacterial models could not recover after 24 hrs of the incubation period.However, high concentration (200 mg/ml) showed bactericidal activity towards P. aeruginosa.The potency of C. albiceps extract toward gram-negative bacteria has been proven by agar disc diffusion assay which failed to show any antibacterial efficiency of ES toward gram-positive bacteria.Synergism between larval ES and commercial antibiotics against all bacterial species was observed.The present data is promising and using these combinations can lead to a reduction in the minimum dose required for effective antimicrobial effects which is important because it may decrease both the risk of side effects and the costs of treatment of infectious diseases.
2020-04-01 | Antibacterial Activities of Chrysomya albiceps Maggots’ Extracts (Diptera: Calliphoridae)
Maggot therapy's success is partly due to the ingestion and killing of living microorganisms. The aim of this study was to investigate the antibacterial activities of maggots’ crude extracts (DMSO and PBS extracts) and excretion/secretion of Chrysomya albiceps (Diptera: Calliphoridae). The excretion/secretion (E/S) and crude extracts were collected from third larval instars of C. albiceps. The extracts were tested against Escherichia coli and Pseudomonous aeruginosa, as Gram-negative bacteria and Staphylococcus aureus and Bacillus subtilis as Gram-positive bacteria. Antimicrobial activity was done by calculating the reduction percentage of the colony's growth. The E/S was appeared the highest antibacterial activities against Gram-positive and Gram-negative bacteria, while the PBS extract has appeared the lower antibacterial activities. Generally, the E/S of C. albiceps maggot was found to be more effective as antibacterial agents than crude extracts (DMSO and PBS extracts).
2017-07-01 | Molecular characterization of matrix metalloproteinase-1 (MMP-1) in Lucilia sericata larvae for potential therapeutic applications
The salivary glands of Lucilia sericata are the first organs to express specific endopeptidase enzymes. These enzymes play a central role in wound healing, and they have potential to be used therapeutically. Rapid amplification of cDNA ends and rapid amplification of genomic ends were used to identify the coding sequence of MMP-1 from L. sericata. Different segments of MMP1 gene, namely the middle part, 3′ end, and 5′ end, were cloned, sequenced, and analyzed using bioinformatics tools to determine the distinct features of MMP-1 protein. Assembling the different segments revealed that the complete mRNA sequence of MMP-1 is 1932 bp long. CDS is 1212 bp long and is responsible for the production of MMP-1 of 404 amino acid residues with a predicted molecular weight of 45.1 kDa. The middle part, 3′ end, and 5′ end sequences were 933, 503, and 496 bp. In addition, it was revealed that the MMP-1 genomic sequence includes three exons and two introns. Furthermore, the three-dimensional structure of L. sericata MMP-1 protein was evaluated, and its alignment defined that it has high similarity to chain A of human MMP-2 with 100% confidence, 72% coverage, and 38% identity according to the SWISS-MODEL modeling analysis. MMP-1 of L. sericata has a close relationship with its homologs in invertebrates and other insects. The present study significantly contributes to understanding the function, classification, and evolution of the characterized MMP-1 from L. sericata and provides basic required information for the development of an effective medical bioproduct.
2016-11-21 | The transcriptional responses of cultured wound cells to the excretions and secretions of medicinal Lucilia sericata larvae.
Maggots, through their excretions and secretions (ES), promote wound healing by removing necrotic tissue, counter bacterial infection, and activate wound associated cells. We investigated the effects of a physiological dose of maggot ES on four wound-associated cell types in vitro with Affymetrix gene expression arrays; keratinocytes, endothelial cells, fibroblasts, and monocytes. Keratinocytes showed the fewest (n = 5; p < 0.05, fold-change ±2) and smallest fold-changes (up to 2.32×) in gene expression and conversely THP1 monocytes had the most (n = 233) and greatest magnitude (up to 44.3×). There were no genes that were altered in all four cell-lines. Gene pathway analysis identified an enrichment of immune response pathways in three of the treated cell-lines. Analyses by quantitative RT-PCR found many genes dynamically expressed in ES dose dependent manner during the three day treatments. Phenotype analyses, however, found no effects of ES on cell viability, proliferation, migration and angiogenesis. ES was 100× less potent at triggering IL-8 secretion than fibroblasts treated with purified bacterial lipopolysaccharide (LPS; in equivalent amounts to that found in ES; ∼40 EU/ml). Furthermore, co-treatment with LPS and ES decreased the LPS-alone triggered IL-8 secretion by 13%. Although ES had no direct effect on wound cell phenotypes it did partially reduce the immune response to bacterial LPS exposure. These observations were consistent with the profile of transcriptional responses that were dominated by modulation of immune response genes. Maggot therapy may therefore improve wound healing through the secondary effects of these gene changes in the wound cells.
cell therapies
2025-11-03 | What is the best way to care for a myiasis wound?
The management of myiasis wounds centers on manual removal of larvae, thorough cleaning, and preventing secondary infections, with options like Maggot Debridement Therapy offering biologically based debridement.
2025-08-11 | Beyond Myiasis: Understanding Environmental Factors, Maggots, and Infection Risks in Xylazine-Associated Wounds.
The emergence of xylazine-associated wounds, highlighted by case reports from Philadelphia in 2022, has been linked to the use of this veterinary sedative as an adulterant in the unregulated drug supply and has brought renewed attention to the challenges of complex wound management, particularly in vulnerable populations. Among these challenges are unusual infectious complications, including cases of larva-associated infections such as Ignatzschineria bacteremia in maggot-colonized wounds, raising critical questions about the role of environmental exposure, wound neglect, and the presence of maggots. Clinicians must recognize that rare infections often arise not from the drug itself but from environmental exposure and delayed wound care. Furthermore, it is essential to distinguish between uncontrolled myiasis (spontaneous, unsanitary maggot infestation) and the therapeutic application of sterile Lucilia sericata larvae through medically supervised larval therapy. Building on historical observations and contemporary wound care literature, we explore how larval therapy offers a precise, cost-effective method for wound debridement, particularly valuable in situations in which definitive surgical care is delayed or unfeasible. As clinicians confront the rising burden of xylazine-related wounds, a nuanced understanding of environmental infectious risks and biosurgical interventions can expand the surgeon's wound care armamentarium and improve outcomes not only for patients with drug-induced wounds but also for individuals with chronic wounds.
2024-02-16 | Therapeutic Potential in Wound Healing of Allogeneic Use of Equine Umbilical Cord Mesenchymal Stem Cells
Wound healing after skin injury is a complex process, particularly in equines where leg wounds are prevalent and their repair is complicated due to the anatomical characteristics. Conventional treatments are not effective enough. The umbilical cord offers an unlimited source of adult mesenchymal stem cells (ucMSCs) from Wharton’s jelly tissue. The present study aims to demonstrate the safety and therapeutic potential of the allogeneic use of equine ucMSCs (e-ucMSCs) in the healing of severe equine leg wounds. The methods employed were the isolation, culture and expansion of e-ucMSCs. Flow cytometry and a PCR assay were used for cell characterization. This study included an immunomodulation assay, a murine pre-clinical trial and the first phase of an equine clinical trial. Our results showed that e-ucMSCs express a functional HLA-G homolog, EQMHCB2. In the immunomodulation assay, the e-ucMSCs inhibited the proliferation of activated equine peripheral blood mononuclear cells (e-PBMCs). In the murine pre-clinical trial, e-ucMSCs reduced healing time by 50%. In the equine clinical trial, the injection of e-ucMSCs into severe leg lesions improved the closure time and quality of the tissues involved, regenerating them without fibrous tissue scar formation. In conclusion, the results of this study suggest that e-ucMSCs can be used allogeneically for wound healing by creating a tolerogenic environment.
2022-12-18 | Exploring the Effects of Lucilia sericata Larvae on Biofilm-forming Bacteria in Wounds
Objective: Biofilm-induced chronic wound infections are among the most significant causes of treatment failures. Healing chronic wounds with biofilm is a major issue worldwide due to high costs and adverse effects on patients. In this study, we aimed to investigate the impacts of Lucilia sericata larvae on biofilm-forming bacteria in chronic wounds.
Method: We recruited 30 patients applying to Istanbul University-Cerrahpasa, Traditional and Complementary Medicine Research and Application Center, Wound Healing Unit, between December 2019 and March 2021. We obtained swab cultures before and immediately after applying Larval Debridement Therapy (LDT). After identifying isolated bacteria, we examined all agents by susceptibility and biofilm formation.
Results: While isolating only a single bacterial genus/species in 19 patients, we could detect more than one bacterial genus/species in 11 of them. Moreover, we observed biofilm formation in bacteria isolated from 21 patients, but it was not the case in bacteria grown in 9 patients. Following LDT, we discovered that the biofilm layer on wounds was removed in a short time (two to three sessions).
Conclusion: Although many methods are adopted in healing chronic wounds with biofilm formation, they often remain ineffective. The therapy with L. sericata larvae, a simple and effective method, may promote rapid healing of biofilm-forming wounds.
2022-06-28 | A systematic review of effective bioagent in chronic wounds: The maggot biotherapy pyramid
Wound assessment is important in monitoring the effectiveness of treatment in chronic wounds.Therefore, a holistic approach is needed when evaluating effective wound treatment.Most chronic wounds require complementary treatment approaches and conventional treatments in modern medicine.This research was carried out by compiling studies on the past, present, and future of maggot (medical larvae) that cure nonhealing/hard-to-heal wounds; therapeutic larva types, therapy method, healing mechanism, wound healing effect with clinical studies, different usage areas and biological activities of the larvae and the metabolite components in the secretions that provide these activities.In conclusion, medical larvae applied with traditional and complementary medicine techniques to treat nonhealing, difficult-to-heal wounds have a wound-healing effect.However, more research is needed to identify the metabolite components in their secretions that provide their mechanism of action and biological activities.
gene therapies
2022-05-29 | Genomic insights into evolution and control of Wohlfahrtia magnifica, a widely distributed myiasis-causing fly of warm-blooded vertebrates.
Wohlfahrtia magnifica is a pest fly species, invading livestock in many European, African and Asian countries, and causing heavy agroeconomic losses. In the life cycle of this obligatory parasite, adult flies infect the host by depositing the first-stage larvae into body cavities or open wounds. The feeding larvae cause severe (skin) tissue damage and potentially fatal infections if untreated. Despite serious health detriments and agroeconomic concerns, genomic resources for understanding the biology of W. magnifica have so far been lacking. Here, we present a complete genome assembly from a single adult female W. magnifica using a Low-DNA Input workflow for PacBio HiFi library preparation. The de novo assembled genome is 753.99 Mb in length, with a scaffold N50 of 5.00 Mb, consisting of 16,718 predicted protein-encoding genes. Comparative genomic analysis revealed that W. magnifica has the closest phylogenetic relationship to Sarcophaga bullata followed by Lucilia cuprina. Evolutionary analysis of gene families showed expansions of 173 gene families in W. magnifica that were enriched for gene ontology (GO) categories related to immunity, insecticide-resistance mechanisms, heat stress response and cuticle development. In addition, 45 positively selected genes displaying various functions were identified. This new genomic resource contributes to the evolutionary and comparative analysis of dipterous flies and an in-depth understanding of many aspects of W. magnifica biology. Furthermore, it will facilitate the development of novel tools for controlling W. magnifica infection in livestock.
other
2024-01-04 | Antennal Transcriptome and Proteome Analysis of Olfactory Genes and Tissue Expression Profiling of Odorant Binding Proteins in Wohlfahrtia magnifica
Wohlfahrtia magnifica is a species of fly that parasitizes Bactrian camels.The adult flies lay their larvae near the vulva of the camels, and these larvae develop and cause damage to the vaginal tissues, resulting in vaginal myiasis.Olfactory organs play an important role in the identification and location of host, foraging, mating and oviposition behavior of W. magnifica.Olfactory genes were identified by antennal transcriptome analysis.Twenty-four odor-binding proteins (OBPs) and two chemosensory proteins (CSPs) were identified in the antenna transcriptome of W. magnifica, and then the phylogenetic analysis of the olfactory genes of W. magnifica and other species was carried out.RT-qPCR was used for the first time to analyze the expression profile of OBPs in the antenna tissues of the W. magnifica.In the tissue expression analysis of OBP genes, it was found that many of them showed obvious gender bias in antennae, indicating their different roles in identifying pheromones.These results will help to lay a foundation for the future research on the sense of smell of W. magnifica and help to better reveal the change of odor reception of W. magnifica and provide new ideas for the research on biological prevention and control of vaginal myiasis.
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